6 Ways to Negotiate Lower Prices with your Healthcare Providers
October 12, 2009
Vol. 5, Issue 9
Here in American and all across the world, it is common for consumers to negotiate with vendors for lower rates. When houses, cars, and other expensive items are bought and sold, negotiation is quite common.
Yet for some reason many people feel they cannot negotiate for medical services.
This is hogwash!
If you have a high deductible health insurance plan, then you need to get the best price you can for the medical services you purchase, and you should never be afraid to ask for a lower price. We pay a lot of money for medical care in this country, and there is often some “wiggle room” on the price. And I don’t believe you should ever pay more than you really have to.
Here are some of my best tips to help you negotiate with your healthcare providers for lower rates.
1. Research the Market
As with the sale of goods or services in any industry, there is a huge price variation from vendor to vendor in the healthcare industry. Often the most expensive doctors and hospitals are not necessarily the best.
As a consumer, how can you be sure that you are getting the best possible rate for the healthcare services you require? The answer is simple: do your research. Here are some effective methods that you can use to research what healthcare providers are charging – and what people might actually be paying – for services:
different healthcare providers and ask them how much they charge for the service(s)
you need. Even if you prefer to use your current healthcare provider, you
may be able to negotiate a lower rate with your current provider if you can
find a lower rate elsewhere and propose that your current provider charge
you the lower rate. Remember: it’s okay to ask and your current
healthcare provider shouldn’t be offended by your spending savvy.
online to see what you can find out about rates for services in your
area. Some healthcare providers post rates for common services on their
Web sites. Compare the rates of as many local healthcare providers as
possible. You can use these rates to negotiate with your current healthcare
provider if your healthcare provider has a higher rate than another local
healthcare provider. Also, researching local rates will help you to
understand the local market better.
out online forums. Not all healthcare providers will post their
rates on their own Web sites, but you may be able to find forums
in your area where consumers just like you have posted feedback about a provider
they have used or have heard about. You can also look for forums where
consumers discuss the quality of care that they have received from
their local healthcare providers. Both price and quality are important when
looking for healthcare services.
- Find the rates that Medicare pays for services (learn more about Medicare below). Ask your healthcare provider to give you the same rate that they give Medicare recipients.
Important consumer tip: Not all healthcare services are truly comparable, even if the price for their service is comparable. Along with the price of a service, it is also important that you consider the quality of the service and exactly what is included in the quoted price. Ask about those “hidden” or “additional” fees that may also be charged:
How do you know what fees to ask about? A good place to start is by asking your healthcare provider what the total fees could be for all services that may be rendered. For example, if you need to have surgery, you may not only need to pay a surgeon’s fee, but you may also need to pay a fee for use of the operatory and anesthesia, in most cases. A service provider should disclose this information to you up front.
Likewise, if you are looking for a dentist for a regular check-up, make sure that you not only find out what the fee is for the office visit, but find out what is included in the visit. Does the visit cover X-rays? Fluoride application? Dental hygienist fees? Asking about not only the main fee for service, but for additional fees is an effective way to ensure that you really are finding the most affordable healthcare provider – and comparing fees fairly.
2. Check Out What Medicare and Other Government Programs are Paying
The federal government is the largest payor of the American healthcare market, thanks to 3 well-used programs that pay for the medical expenses of participants: Medicare, Medicaid, and TRICARE. Medicare pays for the medical expenses of 44 millions, Medicaid pays for 42 million Americans, and TRICARE covers 9 million Americans.
As the largest healthcare payor, the government has the privilege of setting the rates it will pay for healthcare services. Healthcare providers, therefore, are legally obligated to charge the rates set by the government if they agree to accept Medicare, Medicaid, and TRICARE. These rates may be adjusted based on geography and severity. For example, healthcare providers located in regions where people have higher average incomes may be eligible to receive higher reimbursement rates than providers in regions where the population earns less.
In order to find the lowest possible rates for healthcare, a good place to start may be to look at public records for Medicare reimbursement rates. These public records may help you to negotiate rates that are close to (or equal to) the Medicare rates for services. To find out what Medicare rates your local healthcare providers are charging, check with your state’s health department, your state’s Social Services department, or your State Corporation Commission (SCC).
3. Ask for a Flat Rate Fee
Some healthcare providers, such as hospitals, may agree to charge a flat rate for services rendered – before you are actually admitted. In such a scenario, the Hospital will charge you a predetermined fee, regardless of what procedures need to be performed during your visit.
The hospital, in essence, is taking a gamble that their costs will be less than the flat rate. In the long run, the provider may benefit by securing your business for years down the road, even if they lose money on the initial service they provide to you.
4. Negotiate Before a Service is Rendered
In order to get the best possible outcome during your negotiations with a healthcare provider, be sure to negotiate before a healthcare service is rendered, if at all possible. Many doctors are more willing to negotiate on fees if you approach them upfront before they begin work. Often if they simply understand that you are looking for the most affordable service provider, they will adjust their rates to meet your budget.
5. Shop for the Right Pharmacy
As with healthcare services, there is a huge price discrepancy for medications. In fact, according to one survey, the price differences for retail medications may vary by as much as 40 percent from one pharmacy to the next. Simply put: you cannot afford not to shop around for the best prescription drug rates. Also, be sure to look online for discount pharmacies located within the U.S. that may provide extra-low rates for medications – and eliminate the need for you to travel to the pharmacy to pick them up!
Heads up: generic medications may be available for many popular retail medications. Many pharmacies offer lower rates or fixed rates for generic medications. If there is a generic option available for your medication, look for a pharmacy that will sell you that medication for a fixed rate of $4 or $10, such as Walmart or Target.
6. Use Our Bill Negotiation Service
Many consumers find that they are able to get lower bills when they turn to a third-party negotiator who will act on their behalf to lower their medical bills from healthcare providers. We recommend a Bill Negotiation Service to all of our customers. This provides you with a third-party negotiator who will work with your healthcare providers to attempt to lower your medical bills. If the negotiators are able to lower your medical bills, you will receive 70 percent of the amount of money saved. If they are unable to lower your medical bills, you will not be charged for the service.
Remember, it’s your money, and a lot of other people want it. Spend it wisely, and do not be afraid to ask for a lower price.
P.S. - Next month we’ll take a look at healthcare reform, and how coming changes may affect you.